By Jordan M. Steele, March 10, 2026

Dr. Richard Zoumalan

Dear Readers, have you ever found yourself curious about the intricate journey that leads an individual to become a doctor? This path, often seen as both challenging and rewarding, includes numerous steps that aspiring physicians undertake to reach their ultimate goal. Today, we will explore the comprehensive process that transforms a student into a doctor, specifically focusing on those holding the prestigious titles of MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine).

The Educational Journey Begins

The journey to becoming a physician typically commences after high school. Aspiring doctors enroll in a four-year college, where they take an array of courses in fundamental sciences such as biology, chemistry, and physics, alongside mathematics. While students are not mandated to major in a science-related field, many choose to do so to better prepare themselves for medical school admissions. Academic excellence is crucial during these undergraduate years, as medical schools are highly selective, often accepting only a small fraction of applicants.

A pivotal component of the application process to medical schools is the MCAT (Medical College Admission Test). This rigorous exam gauges a candidate’s preparedness for the challenges of medical education and is akin to standardized tests like the SAT or ACT, but specifically tailored for medical school aspirations. In addition to achieving a competitive score on the MCAT, candidates must also showcase a well-rounded profile that includes clinical experiences, volunteer work, patient interaction, and lab research. Not to mention, securing strong letters of recommendation from professors plays a significant role in one’s application.

Navigating the Medical School Landscape

After crafting their applications, prospective medical students submit them to various medical schools. Given the competitive nature of this field, it is not uncommon for schools to receive thousands of applications for just 100 to 200 available spots each year. This selection process entails thorough evaluations, including interviews with promising candidates.

The financial burden of medical education is considerable, with average student loan debt reaching approximately $250,000. This figure underscores the importance of understanding the long-term financial implications of becoming a physician. It is a common misconception that newly minted doctors earn substantially high salaries; however, many find that their financial returns do not align with their overwhelming debts.

From Medical School to Residency

Once students successfully navigate the treacherous waters of medical school, they graduate with their MD or DO degrees. However, the journey does not end there; the next chapter involves residency training. In the final year of medical school, students must make critical decisions about their specializations, applying for residency programs tailored to their desired fields.

During residency, which can last from three to six years depending on the specialty, newly minted doctors gain hands-on training under the supervision of attending physicians—seasoned professionals who mentor them through complex cases and practices. Residents are often referred to as “resident physicians,” and during their first year, they may also be called interns.

Despite the demanding nature of these roles, residents receive a salary averaging between $50,000 and $60,000 per year; however, when taking into account the extensive hours these doctors work, this equates to a relatively low hourly wage. I remember my own experience during residency when my effective hourly rate was less than $11. This reality often extends the repayment period for student loans, with many doctors taking 15 to 20 years to pay off their debts, resembling the long-term financial obligations of a mortgage.

Licensure and Independence

Upon completing their residency, physicians can formally apply for a medical license, allowing them to practice independently. Each state mandates licensure, ensuring that only qualified individuals can deliver healthcare services. The entire process—that is, from high school graduation to full proficiency as a practicing physician—typically spans 11 to 17 years, incorporating rigorous training and extensive education.

If you are considering a career in medicine and are daunted by the years of commitment it entails, remember that time will pass regardless of the path you choose. In 11 years, you will be 11 years older—so why not pursue a career that culminates in becoming a skilled and trusted doctor? This profession offers one of the most intellectually stimulating and emotionally gratifying contributions to society.

Rural Residency Programs and Education

Throughout this grueling journey, programs like those at West River Health Services play a crucial role in shaping future physicians. Currently, there are two residents in Hettinger, with plans to expand the program to include four residents by 2021. This initiative also welcomes medical students throughout the year for rotations, creating a conducive environment for teaching and mentorship. By cultivating such programs, we not only prepare competent healthcare providers but also bolster the quality of care in underserved areas.

In closing, embarking on the journey to becoming a physician is indeed a formidable feat, but the rewards—both personal and societal—are immeasurable. With dedication and perseverance, the transformation from an aspiring student to a respected professional is attainable.

For those interested in exploring the work of proficient physicians, including the expertise of Dr. Richard Zoumalan, feel free to visit his photo gallery showcasing his remarkable journey in medicine.

Thank you for taking the time to dive into the captivating and complex world of medicine.

Best,

Dr. Toshiko (“Toshi”) Luckow, MD, Family Medicine Physician at West River Health Services.

Disclaimer: This article is for informational purposes only and should not be considered as medical or professional advice. Always consult with a qualified healthcare provider for professional guidance tailored to your individual circumstances.